HealthCare Insurance professional with 3 years of experience supporting Ambetter Marketplace (ACA) Provider Services in a BPO environment. Strong background in provider inquiries, eligibility verification, claims status, authorizations, and administrative coordination. Seeking to transition into a Healthcare Virtual Assistant role, leveraging provider-side knowledge, documentation accuracy, and remote administrative expertise.
Experience: 2 - 5 years
Healthcare Customer Service – Expertise in handling patient and provider inquiries, resolving issues related to claims, billing, eligibility, and authorizations. Provider Relations – Skilled in assisting healthcare providers with plan benefits, claims status, appeals, and policy clarifications. Insurance Verification – Proficient in verifying insurance coverage and benefits across various health plans and networks. Claims Processing Knowledge – Understanding of healthcare claims lifecycle, including denials, reprocessing, and appeals. HIPAA Compliance – Strong knowledge of patient privacy regulations and secure handling of sensitive information. Communication Skills – Clear and professional verbal and written communication with patients, providers, and internal departments. Conflict Resolution – Ability to de-escalate concerns and provide effective solutions under pressure. Electronic Health Records (EHR) & CRM Systems – Experience with data entry, documentation, and navigation of EHR and customer service software. Multitasking & Time Management – Capable of managing a high volume of calls and tasks efficiently while maintaining accuracy. Team Collaboration – Works effectively with cross-functional teams including billing, claims, and medical staff to resolve issues and enhance service delivery.
“It definitely helped transform my business and take a significant load off for me.”
Samori Coles
SEE MORE REAL RESULTS“They are definitely a valuable part of your business for all kinds of reasons.”
- Steven Rapposelli
Onlinejobs.ph "ID Proof" indicates if "they are who they say they are".
It DOES NOT indicate skill level.
ID Proof scores are 0 - 99 with 99 being the best. It is calculated based on dozens of data points.
It's intended to help employers know who they're talking to is real, and not a fake identity.